Drug

bethanechol

Therapeutic Use
Atonic Bladder

Classification
Direct-acting muscarinic agonist

Mechanism of Action
At recommended doses it is relatively selective for muscarinic receptors in smooth muscle of urinary bladder and intestinal wall; activates receptors causing contraction of smooth muscle in wall of the bladder and GI tract

Mechanism Based Adverse Effects

Miosis Bradycardia Lacrimation Salivation Sweat Bronchial secretions HCl, Pepsin

Contraindications/ Precautions
Asthma Bradycardia Gastric ulcers

edrophonium

pyridostigmine

Diagnosis of Myasthenia gravis; fast acting, short lasting Treatment of Myasthenia gravis; used because has longer lasting effects and is H2O soluble therefore cannot pass the blood brain barrier

Reversible indirectacting cholinergic agent AKA Anitcholinesterase Reversible indirectacting cholinergic agent AKA Anitcholinesterase

(same as direct-acting cholinergic agonist) Miosis Temporarily occupies ACh active binding site on AChE therefore stopping ACh from binding to AChE and getting broken down. This leads to increasing levels of ACh in synapse, producing parasympathetic effects. AND Muscle tremors Muscle cramps Bradycardia Lacrimation Salivation Sweat Bronchial secretions HCl, Pepsin

(same as direct-acting cholinergic agonist) Asthma Bradycardia Gastric ulcers

Organophosphates pralidoxime 2PAM atropine (emergency drug)

Antidote for organophosphate poisoning Antidote for organophosphate poisoning Sinus bradycardia

Cholinesterase reactivator Muscarinic receptor antagonist

Breaks the bond between an organophosphate and AChE At recommended doses it is a selective muscarinic receptor antagonist. It binds to muscarinic receptors

Gastrointestinal motility Urinary retention because of constriction of internal sphincter and relaxation of

Tachycardia atropine can easily cause a tachycardia GI obstruction

Atrioventricular block Ventricular asystole when due to excessive parasympathetic tone Stop ciliary muscle spasms in the eye

but does not activate it. Because atropine occupies the binding site on M receptor and does not activate it, it blocks ACh from binding to M receptor, blocking muscarinic receptors, causing antimuscarinic effects (blocks effects of parasympathetic nervous system).

bladder wall Intestinal ileus in horses- can be fatal CNS effects (usually at higher doses) because atropine is lipid soluble; anxiety, restlessness, disorientation. (opposite effects of organophosphates)

Urinary obstruction Narrow angle glaucoma DO NOT GIVE TO Ruminants, can cause: - CNS toxicities - Rumen stasis Give recommended dose because if you give less than recommended dose it will actually decrease HR

glycopyrrolate

Before and after general anesthesia to: - suppress bronchial secretions - suppress salivary secretions - treat bradycardia resulting from vagal stimulation Same as above Note: - CAN be used in horses and ruminants - More polar molecule than atropine, so it doesnt easily cross the blood brain barrier or placental barriers therefore anticholinergic of choice in c-

Muscarinic receptor antagonist

Same as above, but effects less common

Narrow angle glaucoma Tachycardia GI obstruction Urinary Obstruction

sections and CNS effects uncommon Slower onset and longer duration than atropine Less likely to cause a tachycardia than atropine Nicotinic receptor antagonist Selective for insect nicotinic receptors specifically fleas, blocks nicotinic receptors on the skeletal muscle causing paralysis. Interacts with and activates: 1 contraction of vascular smooth muscle in skin, mucous membranes, viscera and kidneys leading to blood vessel constriction in those areas. 1 HR, Force of contraction, Speed of AV conduction of heart 2 Very powerfully relaxes airway smooth muscle, causing powerful relaxation, bronchodilation Dose dependent: Very low doses DA receptors in renal and mesenteric arterioles vasodilation in renal and mesenteric vascular beds

nitenpyram

Epinephrine

Anaphylactic shock Prolong effects of local anesthetic agent Prevent capillary bleeding Cardiac arrest, causes by: Ventricular fibrillation Ventricular asystole Pulseless electrical activity (PEA) Shock (moderate to high dose) Refractory congestive heart failure

Catecholamine direct-acting adrenergic agonist

Very Arrhythomogenic Hypertension or hypotension CNS effects anxiety, restlessness, fear, tremors, excitability Adrenergic effects

Dopamine (DA)

Catecholamine direct-acting adrenergic agonist

Arrhythomogenic Hypertension or hypotension CNS effects anxiety, restlessness, fear, tremors, excitability

Avoid extravasation (outside vein) because is very irritating and can lead to necrosis and sloughing

Moderate doses 1 HR, Force of contraction, Speed of AV conduction of heart High doses 1 vasoconstriction all around the body Synthetic Therapeutic doses catecholamine direct- 1 but increases force acting adrenergic of contraction MORE agonist than increases HR Higher doses 1 and 2

Adrenergic effects

Dobutamine

Shock Refractory congestive heart failure

Very Arrhythomogenic Hypertension or hypotension CNS effects anxiety, restlessness, fear, tremors, excitability Adrenergic effects Reflex Tachycardia Very Arrhythomogenic Hypertension or hypotension CNS effects anxiety, restlessness, fear, tremors, excitability Adrenergic effects

Isoproterenol

3rd degree AV block

Synthetic Stimulates 1 and 2 catecholamine direct- very powerfully more acting adrenergic than epi agonist HR Bronchodilation Widespread vasodilation BP

albuterol

Bronchodilator in treatment of asthma In people, relax pregnant uterus

2 Selective adrenergic agonist

At recommended doses, is selective for 2 receptors, little direct stimulation of 1 receptors at heart 2 Bronchodilation Stimulates 1 , 1, 2 1 contraction of urethral smooth muscle (sphincter) 2 relaxation of detrusor muscle (bladder wall)

phenylpropanolamine (PPA)

Urinary incontinence in dog due to urinary sphincter hypotonus (used to be used as appetite suppressant and decongestant but not anymore because

Adrenergic receptor agonist

Hypertension Cardiac arrhythmias Urinary retention

it caused hemorrhagic stroke)

prazosin phenoxybenzamine
Prevent urethral spasm in treatment of feline lower urinary tract disease (FLUTD) AKA blocked cat

Reversible 1 adrenergic antagonist Irreversible 1 adrenergic antagonist

Blocks 1 receptors: Relaxes urethral smooth muscle

Reflex tachycardia Postural (orthostatic) hypotension Syncope Miosis Vasodilation

propranolol
Cardiac arrhythmias Adjunction therapy in feline hyperthyroidism Feline hypertrophic cardiomyopathy Congestive heart failure

Beta adrenergic receptor antagonist; Beta Blocker

atenolol

1 selective adrenergic antagonist; Cadioselective Beta blocker

Antagonist/ blocks 1 and 2 receptors HR Force of contraction Speed of AV conduction of heart Antagonist/ blocks 1 receptors HR Force of contraction Speed of AV conduction of heart

Bronchoconstriction (2) Cardiac arrhythmias Hypotension